Surgeon General Urges Nation to "Put Prevention into Practice"

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Surgeon General David Satcher, M.D., Ph.D., today joined the Agency for Health Care Policy and Research (AHCPR) and the Office of Disease Prevention and Health Promotion (ODPHP) in urging clinicians, health plans and consumers to work together to make prevention—screening, immunizations and counseling for health behavior change—a part of every health care visit, in every clinical setting.

Dr. Satcher said materials available from the Put Prevention Into Practice (PPIP) initiative make it easier for systems of care, clinicians and their office staffs to deliver recommended prevention services and to perform them properly (select to access About PPIP). The PPIP consumer materials help patients ask about and keep track of their preventive health care.

"Research shows that prevention can help people stay healthier and live longer," said Dr. Satcher, "but we also know that for various reasons—such as confusion due to conflicting recommendations and lack of time—clinicians do not provide all the clinical preventive services their patients need. Moreover, patients continue to ask for preventive services that have been found to be ineffective or to have unproven benefits."

AHCPR Administrator John M. Eisenberg, M.D., said, "Health care research has proven that improving the delivery of clinical preventive care has the potential to make significant improvements in the quality of health care in our Nation. There are too many gaps between the prevention knowledge and tools that scientific advances have given us and the preventive care that Americans actually receive. PPIP is the engine that can move evidence-based findings about prevention, such as those developed by the U.S. Preventive Services Task Force, into the settings where patients receive their health care." AHCPR is the new home for PPIP, which originated with ODPHP and was first released in 1994.

According to Dr. Eisenberg, research clearly shows the need for improvements in the provision of preventive care. In 1997 the National Committee for Quality Assurance released a report showing a wide range of performance by health maintenance organizations and other managed care plans nationwide in the delivery of preventive services and other health care. For example, the report shows that in 1996, 81 percent of New England children under age two in managed care plans received appropriate immunizations, but in the Mountain region the rate was only 59 percent. Plans in the Mid-Atlantic region reported mammography screening ranging from 30 percent to 80 percent. Also, patients in some plans received advice to quit smoking as infrequently as 30 percent of the time, and in other plans as often as 85 percent of the time.

Dr. Eisenberg cited recent AHCPR-supported research showing just how effective prevention can be. In a study published in the December 3, 1997, Journal of the American Medical Association, researchers concluded that if doctors advised each of their patients who smoked to quit, an additional 1.7 million people would quit smoking each year.

The PPIP materials were developed by ODPHP and evaluated with the cooperation of numerous public and private institutions, including the 31 members of the National Coordinating Committee on Clinical Preventive Services, federal liaisons to the Committee, other federal agency experts and many other contributors from academic institutions, State departments of health, professional groups and voluntary organizations.

The Clinician's Handbook of Preventive Services, 2nd Edition, includes summaries of recommendations on screening tests, immunizations and counseling for children/adolescents and adults/older adults by major authorities, including the U.S. Preventive Services Task Force, federal health agencies, national professional organizations, national voluntary health organizations and the Canadian Task Force on the Periodic Health Examination. Instructions for performing the services are included, along with other information to help implement prevention in health care settings.

Print copies of the Personal Health Guide and Child Health Guide are available, free of charge, through the AHCPR Publications Clearinghouse. Contact the Clearinghouse for ordering information for the Clinician's Handbook of Preventive Services, 2nd Edition, and the posters. The Clearinghouse may be reached by calling 800-358-9295 or writing to AHCPR Publications Clearinghouse, P.O. Box 8547, Silver Spring, MD 20907.

Most PPIP materials are available from the AHCPR Web site, and the Clinician's Handbook, 2nd edition, will be coming to it. Select to access: